This proposal involves the use of corticotrophin releasing hormone (CRH) both with and without dexamethasone for the purposes of distinguishing between Cushing's syndrome and pseudo-Cushing's in one patient. At the time of this proposal CRH was still classified as an investigational drug and, thus, could only be used under an approved compassionate use protocol. D.J. had a history of Cushing's syndrome with prior pituitary surgery. Due to her underlying depression and possible methadone interference with ACTH secretion, it was not clear whether her Cushing's had recurred. The "Dex-CRH" test was performed as previously described in the literature from researchers at the NIH to assess for this. Blood and urine tests were performed and revealed that her Cushing's had recurred.